Measurement of doctor wellbeing prior to the Covid pandemic: a methodological systematic review

Background There is no consensus definition of wellbeing, yet it is a key outcome for workforces. Aims To describe which wellbeing outcomes had been measured in doctors and which wellbeing outcome measurement instruments had been used with doctors. Methods A methodological review of existing literature. MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO and the International Bibliography of Social Science were searched for all study types, in all languages. Wellbeing outcomes were categorized as being operationalized in the aims, methods or results and by whether the outcome used to represent wellbeing included the word wellbeing, another positive concept, a pathological symptom, a pathology and were work- or doctor-specific. The outcome measurement instruments used were then categorized and the frequency collected. Results A total of 218 studies were included in this review. The total number of unique outcomes used to capture wellbeing in the eligible studies was 57, with 369 non-unique outcomes. Two hundred and fifty-eight of the outcomes used contained the word wellbeing, its components and other positive concepts. For the outcome ‘general wellbeing’ alone, 92 different measurement tools were used. The Maslach Burnout Inventory was the most frequently used measurement tool for all outcomes and was used in 34 studies. Conclusions Wellbeing has been measured heterogeneously in doctors in terms of the outcomes and the outcome measurement instruments used. In approximately one-third of the times it was measured, the best that could be achieved was an absence of pathological symptoms, as a negative concept operationalized it.